'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Doctors should ask women about domestic violence and abuse when they present at sexual health clinics, a study has advised.

A programme that was initially designed to help GPs identify and refer women experiencing domestic violence and abuse (DVA) has been successfully implemented in sexual health clinics, researchers found.

They suggested that it should be rolled out more widely to fill an unmet domestic violence training need.

The feasibility study, led by researchers from Queen Mary University of London and the University of Bristol, implemented the Identification and Referral to Improve Safety, or IRIS, programme in two walk-in sexual health clinics.

IRIS is an evidence-based intervention that includes DVA training, support for women and referrals to specialist services within primary care.

At one clinic, the domestic violence enquiry rate was 10%, with just under 270 women being asked about whether they were experiencing DVA and of those identified as being at risk, 50% (eight women) were referred to specialist services.

The enquiry rate at the second clinic was 61%, with 79 out of the 1090 women asked affected by abuse and 10% of the identified women referred to specialist services.

The researchers said in the paper: ‘This adaptive pilot study shows that it is feasible to develop and implement an IRIS-based DVA training and referral package for sexual health clinics. The intervention resulted in the identification and referral of women affected by DVA, suggesting that it is a potentially effective intervention.’

Lead researcher Dr Alex Sohal from QMUL said: ‘Women attend sexual health clinics for care of their sexual health but little thought is given to whether the relationship with the person that a woman has sex with directly harms her health.

‘Not only is this a feasible intervention for a sexual health clinic setting, but we also found that clinical leads and busy local DVA service providers were incredibly supportive, with many people understanding the importance of making this work.’